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? RDS is implicated in 30% of neonatal deaths.. ? sPG exposure was not associated with RDS.. ? Avoiding preterm birth remains crucial in RDS prevention..?Sustained blood pressures ?160/110 during pregnancy and the postpartum period require timely antihypertensive therapy. Hospital-level experiences outlining the efforts to improve timely delivery of care within 60?minutes have not been described. The objective of this analysis was to assess changes in care practices of an inpatient obstetrical health care team following the implementation of a quality improvement initiative for severe perinatal hypertension during pregnancy and the postpartum period.
?In January 2016, NorthShore University HealthSystem Evanston Hospital launched a quality improvement initiative focusing on perinatal hypertension, as part of a larger, statewide quality initiative via the Illinois Perinatal Quality Collaborative. We performed a retrospective cohort study of all pregnant and postpartum patients with sustained severely elevated blood pressure (two severely elevated blood pressures ?15?minutes apart) with baseline data from 2015 and data collected during the project from 2016 ? Process of hospital-level implementation of a state quality improvement initiative.. ? Evidence of improvement in care delivery for severe perinatal hypertension (HTN).. ? Episode related debriefing by the clinical team improved perinatal HTN care..
? Process of hospital-level implementation of a state quality improvement initiative.. ? Evidence of improvement in care delivery for severe perinatal hypertension (HTN).. ? Episode related debriefing by the clinical team improved perinatal HTN care..?This study aimed to create a statistical model using clinical and laboratory parameters to predict which patients presenting with pruritus in pregnancy will have elevated total bile acids (TBA) and thus, have a high risk of intrahepatic cholestasis of pregnancy (ICP).
?Retrospective cohort study of patients presenting with pruritus in pregnancy and had TBA sent from a single public hospital from January 1, 2017, to December 31, 2017. Primary outcome is TBA ? 10 ?mol/L. Multivariate logistic regression with stepwise and backward variable selection were used to create predictive models. Four models were compared using Akaike information criterion (AIC), C-statistic, and the DeLong nonparametric approach to test for differences between area under the curve (AUC) of receiver operating characteristic (ROC) curves. Internal validation was performed via fivefold cross-validation technique on the best-fitting, most parsimonious model.
?Of the 320 patients with pruritus, 153 (47.8%) had elevated bile acid levelult triage situations.
? Currently, no standard method to triage pruritus in pregnancy exists.. ? We present a predictive statistical model using five readily available clinical variables.. ? Final calculator yields probability of having intrahepatic cholestasis of pregnancy..
? Currently, no standard method to triage pruritus in pregnancy exists.. ? We present a predictive statistical model using five readily available clinical variables.. ? Final calculator yields probability of having intrahepatic cholestasis of pregnancy..?Despite the Centers for Disease Control and Prevention (CDC) and U.S. Preventive Services Task Force (USPSTF) recommending universal hepatitis C virus (HCV) screening in pregnancy Society for Maternal-Fetal Medicine (SMFM) and American College of Obstetricians and Gynecologists (ACOG) continue to endorse risk-based screening for HCV in pregnancy. We hypothesized that universal screening is associated with increased HCV diagnosis and postpartum linkage to HCV care compared with risk-based screening.
?This retrospective cohort study included pregnant women screened for HCV at a single tertiary-care center. We defined two cohorts women managed with risk-based (January 2014-October 2016) or universal HCV screening (November 2016-December 2018). Screening was performed with ELISA antibody testing and viremia confirmed with HCV ribonucleic acid (RNA) polymerase chain reaction (PCR). Primary outcomes were the rate of HCV screen positivity and postpartum linkage to care.
?From 2014 to 2018, 16,489 women delivetes of HCV follow-up and treatment regardless of screening modality, further studies are needed to address barriers to postpartum linkage to care.
? Ideal screening for HCV in pregnancy is unknown.. ? We explore screening strategies in pregnancy to linkage to HCV care.. ? Regardless of screening strategy there is low rates of postpartum linkage to HCV care..
? Ideal screening for HCV in pregnancy is unknown.. ? We explore screening strategies in pregnancy to linkage to HCV care.. ? Regardless of screening strategy there is low rates of postpartum linkage to HCV care..?There is wide variation in the management of pregnancies complicated by abnormal placental cord insertion (PCI), which includes velamentous cord insertion (VCI) and marginal cord insertion (MCI). We tested the hypothesis that abnormal PCI is associated with small for gestational age (SGA) infants.
?This is a retrospective cohort study of all pregnant patients undergoing anatomic ultrasound at a single institution from 2010 to 2017. Patients with abnormal PCI were matched in a 12 ratio by race, parity, gestational age at the time of ultrasound, and obesity to patients with normal PCIs. The primary outcome was SGA at delivery. Secondary outcomes were cesarean delivery, preterm delivery, cesarean delivery for nonreassuring fetal status, 5-minute Apgar score?&lt;?7, umbilical artery pH?&lt;?7.1, and neonatal intensive care unit admission. These outcomes were compared using univariate and bivariate analyses.
?Abnormal PCI was associated with an increased risk of SGA (relative risk [RR] 2.43; 95% confidence the provider should consider serial growth ultrasounds.. ? There is no difference in obstetric outcomes between VCI and MCI..?Food insecurity is a prominent problem and has been implicated in adverse maternal and neonatal outcomes. This study aims to describe the food insecure population in an urban academic health center perinatal cohort.
?We enrolled 451 postpartum inpatients at the University of Cincinnati Medical Center who completed a questionnaire and were then categorized as food insecure based on U.S. https://www.selleckchem.com/products/s64315-mik665.html Department of Agriculture standardized survey questions. Generalized linear models estimated the relative influence of maternal characteristics on food insecurity.
?Among the study population (?=?426), 18.6% (95% confidence interval 15.2-22.4%) were classified as food insecure. Factors with increased adjusted relative risk on food insecurity include annual household income &lt;$40,000, obesity, and smoking. Food insecure women also reported lower levels of love, satisfaction, and joy, and higher levels of despair.
?We recommend the use of a validated screening tool on all pregnant women with the associated psychosocial stressors and social determinants of health.